EP3738523B1 - Structure de support d'actionneur pour agrafeuse chirurgicale - Google Patents

Structure de support d'actionneur pour agrafeuse chirurgicale Download PDF

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Publication number
EP3738523B1
EP3738523B1 EP20174021.4A EP20174021A EP3738523B1 EP 3738523 B1 EP3738523 B1 EP 3738523B1 EP 20174021 A EP20174021 A EP 20174021A EP 3738523 B1 EP3738523 B1 EP 3738523B1
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EP
European Patent Office
Prior art keywords
actuator
engagement feature
slider
surgical stapler
projections
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP20174021.4A
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German (de)
English (en)
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EP3738523A3 (fr
EP3738523C0 (fr
EP3738523A2 (fr
Inventor
Nicholas D. COURTWRIGHT
Barry Thomas Jamison
Michael S. Cropper
Bradley A. Arnold
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Ethicon LLC
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Ethicon LLC
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Publication of EP3738523A3 publication Critical patent/EP3738523A3/fr
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Publication of EP3738523B1 publication Critical patent/EP3738523B1/fr
Publication of EP3738523C0 publication Critical patent/EP3738523C0/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A61B17/105—Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A61B2017/00429—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping with a roughened portion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter

Definitions

  • the invention relates to surgical stapling instruments and associated components.
  • a linear surgical stapler generally includes a first half (referred to as a “cartridge half or “reload half') having a distal jaw configured to support a staple cartridge (or “reload”), and a second half (referred to as an "anvil half') having a distal jaw that supports an anvil surface having staple forming features.
  • the stapler further includes a moveable clamp lever configured to releasably clamp the stapler halves together.
  • the stapler halves are configured to pivot relative to one another to receive and clamp tissue between the two distal jaws when the clamp lever is closed.
  • a firing assembly of the stapler is configured to be actuated to cut the clamped layers and simultaneously drive staples through the tissue on either side of the cut line. After firing the stapler, the clamp lever may be opened and the stapler halves separated to release the severed and stapled tissue.
  • US 2011/068145 A1 describes a surgical stapling instrument including an actuator knob which can be moved from one side of the stapling instrument to another side in order to reposition the actuator knob without having to reposition the stapling instrument within a surgical site.
  • the stapling instrument includes a pusher bar, a housing having a first side and a second side, and an actuator knob rotatably mounted to the pusher bar wherein the actuator knob is configured to be rotated between a first position in which the actuator knob can be moved along the first side of the housing and a second position where the actuator knob can be moved along a second side of the housing.
  • a first retention projection can move out of a retention slot in an end post and into a receiving slot in the driver bar, and a second retention projection can be moved to a position in a channel.
  • FIGS. 1 to 7 and FIGS. 11 to 19 depict embodiments of the invention.
  • FIGS. 8 to 10 depict exemplary arrangements for a firing assembly which are intended to contextualize the present invention.
  • proximal and distal are defined herein relative to a surgeon, or other operator, grasping a surgical instrument having a distal surgical end effector.
  • proximal refers to the position of an element arranged closer to the surgeon
  • distal refers to the position of an element arranged closer to the surgical end effector of the surgical instrument and further away from the surgeon.
  • spatial terms such as “upper,” “lower,” “vertical,” “horizontal,” or the like are used herein with reference to the drawings, it will be appreciated that such terms are used for exemplary description purposes only and are not intended to be limiting or absolute. In that regard, it will be understood that surgical instruments such as those disclosed herein may be used in a variety of orientations and positions not limited to those shown and described herein.
  • FIGS. 1 and 2 show an exemplary linear surgical stapler (10) (also referred to as a "linear cutter") suitable for use in a variety of cutting and stapling procedures, such as a gastrointestinal anastomosis procedure.
  • Linear surgical stapler (10) includes a cartridge half (12) (also referred to as a "reload half') and an anvil half (14) configured to releasably couple together to clamp tissue therebetween.
  • Cartridge half (12) includes a frame (16).
  • Frame (16) is shown as being generally U-shaped to form an elongate channel.
  • Frame (16) includes a proximal frame portion (18), a distal frame portion (20), and a pair of upright side flanges (22) arranged medially therebetween.
  • Proximal frame portion (18) slidably retains a portion of a firing assembly (34).
  • Distal jaw portion (20) supports a staple cartridge (80) (or "reload”).
  • Cartridge half (12) further includes a clamp lever (24) pivotably coupled to an underside of frame (16) in approximate alignment with side flanges (22).
  • Clamp lever (24) includes an elongate lever arm (26) having a free proximal end and a distal end that is pivotably coupled to frame (16) with a pivot pin (28).
  • a pair of opposed jaws (30) extends distally from the distal end of lever arm (26) alongside flanges (22) of frame (16).
  • Each jaw (30) includes a respective elongate slot (32) having a closed proximal end and an open distal end, and which defines upper and lower camming surfaces configured to engage a respective latch projection (56) of anvil half (14).
  • clamp lever (24) is operable to pivot relative to frame (16) between open and closed positions to releasably clamp anvil half (14) against cartridge half (12) and thereby capture tissue layers therebetween.
  • firing assembly (34) of cartridge half (12) includes a slider (36), shown schematically, slidably retained within proximal frame portion (18) of frame (16), an actuator (38) (or “firing knob") movably coupled with slider (36), and an elongate actuating beam (not shown) extending distally from slider (36) and configured to couple with a sled (100) (shown in FIG. 3 ) housed within staple cartridge (80).
  • Actuator (38) of the present example is configured to pivot about the proximal end of cartridge half (12) to provide for "dual-sided firing" of stapler (10).
  • actuator (38) may be positioned along either lateral side of cartridge half (12) to perform a distal firing stroke, such that stapler (10) may be conveniently fired in a variety of orientations during a surgical procedure.
  • Slider (36) is configured to be translatably driven within proximal frame portion (18) by actuator (38) between a proximal home position shown in FIGS. 2 and 5A , and a distal fired position shown in FIG. 5B .
  • actuator (38) In the proximal home position, slider (36) abuts a post (40) fixed at a proximal end of frame (16).
  • a free end of post (40) supports a laterally extending pivot pin (42).
  • actuator (38) may be driven distally when stapler halves (12, 14) are fully coupled together and clamp lever (24) is closed.
  • Distal advancement of actuator (38) along either lateral side of stapler (10) drives slider (36) and the elongate actuating beam distally, which in turn drives sled (100) distally through staple cartridge (80).
  • sled (100) distally through staple cartridge (80)
  • distal translation of sled (100) through staple cartridge (80) provides for simultaneous stapling and cutting of tissue clamped between stapler halves (12, 14).
  • anvil half (14) of linear surgical stapler (10) includes an elongate anvil channel (50) having a proximal frame portion (52) and a distal jaw portion (54).
  • Anvil channel (50) further includes a latch feature in the form of a pair of projections (56) that extend transversely from a medial portion of anvil channel (50) in a direction toward cartridge half (12).
  • Each latch projection (56) may include a circular rotating cap configured to be captured within slot (32) of a respective clamp lever jaw (30) when anvil half (14) is coupled with cartridge half (12) and clamp lever (24) is pivoted from the open position to the closed position, as described below.
  • a pair of hooks (58) extend proximally from a proximal end of frame portion (52) and are configured to releasably capture opposed lateral ends of proximal pivot pin (42) of cartridge half (12).
  • Distal jaw portion (54) supports an anvil surface in the form of an anvil plate (60) having a plurality of staple forming pockets (not shown), and additionally supports a distal tip member (62).
  • the anvil surface may be formed integrally with or otherwise be rigidly connected to distal jaw portion (54) of anvil channel (50).
  • Anvil half (14) of the present example further includes a staple height adjustment mechanism (64) mounted to a medial portion of anvil channel (50).
  • Staple height adjustment mechanism (64) is operatively coupled with anvil plate (60), for example, via one or more camming features (not shown), and includes a pair of user-engageable projections (66). Longitudinal adjustment of projections (66) between a plurality of predetermined positions causes anvil plate (60) to move transversely relative to distal jaw portion (54) of anvil channel (50). This enables adjustment of a transverse gap distance between anvil plate (60) and a deck (94) of staple cartridge (80) that defines the height of staples being formed.
  • staple height adjustment mechanism (64) may be omitted in some versions, in which case the anvil surface may be fixed relative to anvil channel (50). For instance, the anvil surface may be formed integrally with or otherwise fixedly secured to distal jaw portion (54).
  • linear surgical stapler (10) further includes a plurality of shrouds (70, 72, 74) that cover select portions of stapler (10) and promote effective grip and manipulation of stapler (10) by an operator during use.
  • cartridge half (12) includes shroud (70) that covers an outwardly facing side of proximal frame portion (18) of frame (16).
  • Cartridge half (12) further includes shroud (72) that covers an outwardly facing side of clamp lever (24) and is configured to pivot with clamp lever (24) relative to frame (16) and shroud (70).
  • Anvil half (14) includes shroud (74) that covers an outwardly facing side of proximal frame portion (52) of anvil channel (50), including proximal hooks (58).
  • Each shroud (70, 72, 74) may be coupled with its respective components of stapler (10) by any suitable means apparent to those of ordinary skill in the art. Additionally, each shroud (70, 72, 74) may be formed of one or more materials and be provided with texturing suitable to promote effective gripping of the shroud (70, 72, 74) by an operator to enable safe and efficient use of stapler (10) during a surgical procedure.
  • staple cartridge (80) of the present example is an assembly that comprises a cartridge body (82), a pan (84) that covers an open lower side of cartridge body (82), and a plurality of staple drivers (86) housed within cartridge body (82) and each being configured to drive a respective staple (88).
  • Cartridge body (82) includes a proximal end having engagement features (90) configured to releasably engage corresponding engagement features (not shown) of distal jaw portion (20) of frame (16), and a distal end defining a tapered nose (92).
  • An upper side of cartridge body (82) defines a generally planar deck (94) through which a longitudinal slot (96) and a plurality of staple cavities (98) open.
  • Each staple cavity (98) houses a respective staple driver (86) and staple (88).
  • an interior of cartridge body (82) slidably houses sled (100) that comprises a sled body (102) and knife member (104). Lateral sides of sled body (102) support a plurality of cam ramps (106) that taper distally.
  • a proximal end of sled body (102) includes a downwardly extending tab (108) configured to lockingly engage a distal end of the elongate actuating beam (not shown) of firing assembly (34) when staple cartridge (80) is mounted to cartridge half (12) of stapler (10).
  • Knife member (104) extends upwardly from an upper side of sled body (102) and presents a distally facing cutting edge (110) configured to cut tissue.
  • Sled (100) is configured to translate distally through cartridge body (82) in response to distal actuation of firing assembly (34), such that knife member (104) translates distally through longitudinal slot (96) to cut tissue clamped between stapler halves (12, 14).
  • cam ramps (106) translate distally through respective interior slots (not shown) of cartridge body (82) to actuate staple drivers (86) and staples (88) upwardly through staple cavities (98) so that free ends of staples (88) pierce through the clamped tissue and deform against staple forming pockets of anvil plate (60).
  • distal actuation of firing assembly (34) provides for simultaneous severing and stapling of tissue clamped between the distal end effector portions of stapler halves (12, 14).
  • Linear surgical stapler (10) and staple cartridge (80) may be further configured and operable in accordance with one or more teachings of U.S. Pat. 7,905,381, entitled “Surgical Stapling Instrument with Cutting Member Arrangement,” issued March 15, 2011 ; U.S. Pat. No. 7,954,686, entitled “Surgical Stapler with Apparatus for Adjusting Staple Height,” issued June 7, 2011 ; U.S. Pat. No. 8,348,129, entitled “Surgical Stapler Having A Closure Mechanism,” issued January 8, 2013 ; and/or U.S. Pat. No. 8,789,740, entitled “Linear Cutting and Stapling Device with Selectively Disengageable Cutting Member,” issued July 29, 2014 .
  • FIGS. 4A-4C show exemplary coupling of stapler halves (12, 14) during a surgical procedure.
  • the proximal end of anvil half (14) is aligned with the proximal end of cartridge half (12) such that proximal pivot pin (42) of cartridge half (12) is received by proximal hooks (58) of anvil half (14).
  • anvil half (14) With clamp lever (24) in the open position, anvil half (14) is then pivoted toward cartridge half (12), about proximal pivot pin (42), to direct latch projections of anvil half (14) into slots (32) of clamp lever jaws (30). Once latch projections (56) are received by clamp lever jaws (30), clamp lever (24) is pivoted toward the partially closed position shown in FIG. 4B .
  • anvil half (14) is partially clamped with cartridge half (12) such that stapler (10) may now be held with a single hand without halves (12, 14) undesirably separating from one another. Additionally, in this state, the distal portions of stapler halves (12, 14) remain spaced apart from one another to permit positioning of tissue between the distal portions. It will be appreciated that tissue may be positioned between the distal portions of stapler halves (12, 14) before or upon achieving this partially clamped state.
  • clamp lever (24) is then pivoted further toward its fully closed position such that the camming surfaces of clamp lever jaws (30) draw latch projections of anvil half (14) proximally against the closed proximal ends of slots (32) of clamp lever jaws (30), thereby fully clamping stapler halves (12, 14) together with tissue positioned securely therebetween.
  • actuator (38) may be manipulated to fire staple cartridge (80).
  • actuator (38) is pivoted about the proximal end of stapler (10) to overlie one of the lateral sides of stapler (10).
  • Actuator (38) is then driven distally to actuate firing assembly (34) in the manner described above and thereby simultaneously sever and staple the clamped tissue.
  • actuator (38) may be returned to its proximal home position shown in FIG. 2 , and clamp lever (24) may then be opened to separate stapler halves (12, 14) from one another and release the stapled and severed tissue.
  • FIGS. 6-10 show details of firing assembly (34) of linear surgical stapler (10) of FIG. 2 .
  • firing assembly (34) is translatable from a first longitudinal position to a second longitudinal position to fire staple cartridge (80) when first elongate member (shown as anvil half (14)) is clamped against second elongate member (shown as cartridge half (12)).
  • FIG. 6 shows a distal perspective view of firing assembly (34) of linear surgical stapler (10) of FIG. 1 .
  • firing assembly (34) includes slider (36) and actuator (38).
  • FIG. 7 shows a top view of actuator (38) angled relative to a shroud (74) of linear surgical stapler (10) of FIG. 1 , which may occur when an off-center load is applied to actuator (38).
  • slider (36) includes a first body portion (shown as upper body portion (118)), a second body portion (shown as lower body portion (120)), and a third body portion (shown as central body portion (122)).
  • FIG. 8 shows an exploded proximal perspective view of firing assembly (34) of FIG. 6 , where slider (36) is slidably engaged with an elongate channel (109) of proximal frame portion (18) of cartridge half (12) of FIG. 2 , such that slider (36) and actuator (38) move longitudinally as a unit along elongate channel (109).
  • FIG. 9 shows an exploded side elevational view of actuator (38), and upper, lower, and central body portions (118, 120, 122) of firing assembly (34) of FIG. 6 .
  • Actuator (38) is described below with reference to FIGS. 6-10 .
  • Actuator (38) is configured to transmit force applied by the user to firing assembly (34) to perform a transection of tissue.
  • Actuator (38) includes a body (126), where body (126) may include gripping features (128) for improved gripping by a user.
  • Actuator (38) includes an inner engagement feature (130) that extends away from body (126) of actuator (38). As shown, inner engagement feature (130) includes upper and lower arcuate inner projections (132, 134) that face in opposite directions from one another.
  • Actuator (38) also includes upper and lower outer projections (136, 138) that also face in opposite directions from one another.
  • upper and lower arcuate inner projections (132, 134) and upper and lower outer projections (136, 138) extend vertically, and parallel, to body (126) of actuator (38).
  • upper arcuate inner projection (132) and upper outer projection (136) both face vertically upwards
  • lower arcuate inner projection (134) and lower outer projection (138) both face vertically downwards.
  • upper and lower outer projections (136, 138) have a smooth inner surface (140) that extends vertically without any projections or other features extending therefrom.
  • Upper and lower body portions (118, 120) are configured to longitudinally slide into central body portion (122) to collectively form slider (36).
  • Upper body portion (118) includes first and second arms (142, 144) that are separated by a longitudinal slot (146) (shown in FIG. 8 ).
  • First and second arms (142, 144) of upper body portion (118) include an inner engagement feature (148).
  • inner engagement feature (148) is an upper arcuate inner recess (150) that opens into longitudinal slot (146).
  • Upper arcuate inner recess (150) is configured to securably receive and retain upper arcuate inner projection (132) of inner engagement feature (130) of actuator (38).
  • Longitudinal slot (146) is configured to receive central body portion (122).
  • longitudinal slot (146) is configured to accommodate and receive a distal projection (152) of central body portion (122).
  • Upper body portion (118) includes a lower distal projection (154) (shown in FIG. 8 ) that is configured to be received within a distal slot (156) of lower body portion (120).
  • lower body portion (120) includes first and second arms (158, 160) that are separated by a longitudinal slot (162) (shown in FIG. 8 ).
  • First and second arms (158, 160) of lower body portion (120) include an inner engagement feature (164) configured to securably receive and retain inner engagement feature (130) of actuator (38).
  • inner engagement feature (164) is a lower arcuate inner recess (166) that opens into longitudinal slot (162).
  • Upper and lower arcuate inner recesses (150, 166) of upper and lower body portions (118, 120) collectively define a cavity (168) that collectively capture upper and lower arcuate inner projections (132, 134) of inner engagement feature (130) of actuator (38) within cavity (168).
  • Longitudinal slot (162) is configured to receive central body portion (122).
  • lower body portion (120) includes lower rails (170).
  • Actuator (38) may be rotated relative to slider (36) until actuator (38) contacts a stop feature (174) of upper body portion (118) and a stop feature (176) of lower body portion (120).
  • FIGS. 8-9 show central body portion (122) including an inner engagement feature (175).
  • Inner engagement feature (175) may be a C-shaped engagement feature (178), that engages upper and lower arcuate inner projections (132, 134) of inner engagement feature (130) of actuator (38).
  • C-shaped engagement feature (178) includes upper and lower retention features (180, 182) that oppose one another and are shown as being vertically oriented.
  • C-shaped engagement feature (178) forms a cavity (184) that receives upper and lower arcuate inner projections (132, 134) of inner engagement feature (130).
  • Central body portion (122) includes lower rails (186). Lower rails (170) of lower body portion (120) and lower rails (186) of central body portion (122) are configured to slide along elongate channel (109), that forms a track, to vertically guide slider (36) when moved distally.
  • FIG. 10 shows a proximal cross-sectional perspective view of linear surgical stapler (10) of FIG. 6 , where a C-shaped engagement feature (188) collectively formed by upper and lower body portions (118, 120) is engaged with upper and lower arcuate inner projections (132, 134) of inner engagement feature (130) of actuator (38).
  • C-shaped engagement feature (178) of central body portion (122) and C-shaped engagement feature (178) collectively formed by upper and lower body portions (118, 120) create cavities (168, 184) that are aligned to provide a track to prevent inner engagement feature (130) of actuator (38) from detaching.
  • FIG. 7 shows a top view of actuator (38) angled relative to a first shroud of linear surgical stapler (10) of FIG. 1 when an off-center load is applied to actuator (38). Additionally, this deflection may provide an opportunity for actuator (38) to detach from slider (36), which is undesirable. As a result, it may be desirable to strengthen the interface of slider (36) and actuator (38) to prevent, or at least minimize, the deflection of these individual components of firing assembly (34).
  • an exemplary alternative firing system (212) and exemplary linear surgical stapler (310) may limit localized stresses and related deflections on actuator (216, 316) when surgeon-applied, off-center loading creates a torsional load within firing assemblies (212, 312).
  • Firing system (212) and linear surgical stapler (310) enable the individual components of firing assemblies (212, 312) to remain in close proximity to each other and behave as an integrated system rather than individual components during high firing force scenarios.
  • the interface of the individual components of firing assembly (34) may be transformed to firing assembly (212) to minimize undesirable deflection of firing assembly (212).
  • the interface between shrouds (70, 74) and actuator (316) of linear surgical stapler (310) may be transformed to strengthen the interface and minimize undesirable deflection.
  • FIGS. 11-17 show a first exemplary alternative firing assembly (212) for use with a linear surgical stapler, such as linear surgical stapler (10) described above.
  • Firing assembly (212) may be used in place of firing assembly (34) to strengthen firing assembly (212) and minimize undesirable deflection of firing assembly (212).
  • firing assembly (212) is translatable from a first longitudinal position to a second longitudinal position to fire staple cartridge (80) when anvil half (14) is clamped against cartridge half (12).
  • FIG. 11 shows a perspective view of firing assembly (212) as including a slider (214) and an actuator (216), that are similar to slider (36) and actuator (38) described above.
  • Slider (214) includes a first body portion (shown as upper body portion (218)), a second body portion (shown as lower body portion (220)), and a third body portion (shown as central body portion (222)).
  • Upper, lower, and central body portions (218, 220, 222) are similar to upper, lower, and central body portions (118, 120, 122) described above, except as otherwise noted.
  • Upper and lower body portions (218, 220) may be configured to slide longitudinally into central body portion (222) to collectively form slider (214).
  • Upper, lower, and central body portions (218, 220, 222) may be slidable along proximal frame portion (18) of frame (16).
  • Slider (214) is slidably engaged with an elongate channel (109) of proximal frame portion (28) of cartridge half (12) of FIG. 2 , such that slider (214) and actuator (216) may move longitudinally as a unit along elongate channel (109) of proximal frame portion (18).
  • FIGS. 12-14 describe upper, lower, and central body portions (218, 220, 222) in greater detail.
  • FIG. 12 shows an exploded perspective view of firing assembly of FIG. 11 , so that individual features of upper, lower, and central body portions (218, 220, 222) are more easily envisioned.
  • FIG. 13 shows a side elevational view of firing assembly of FIG. 11 , showing the coupling of features of upper, lower, and central body portions (218, 220, 222) with actuator (216).
  • FIG. 14 shows an exploded side elevational view of actuator (216) and upper, lower, and central body portions (218, 220, 222) of firing assembly (212) of FIG. 11 , where actuator (216) and upper, lower, and central body portions (218, 220, 222) each include features to strengthen firing assembly (212) and minimize undesirable deflection of firing assembly (212) as described below.
  • Actuator (216) is described in greater detail below with reference to FIGS. 11 -14A. Similar to actuator (38), actuator (216) is selectively actuated by a user to transmit force applied by the user to firing assembly (212) to perform a transection of tissue.
  • Actuator (216) includes an arm (224) and a body (226). Body (226) may include gripping features (228) for improved gripping by a user. As shown, arm (224) extends perpendicular to body (226) of actuator (216). Arm (224) include inner and outer engagement features (230, 231). Inner engagement feature (230) extends away from body (226) of actuator (216).
  • inner engagement feature (230) includes upper and lower arcuate inner projections (232, 234) that face in opposite directions from one another. As shown in FIGS. 14 and 16 , upper and lower arcuate inner projections (232, 234) extend vertically. Particularly, upper and lower arcuate inner projections (232, 234) extend perpendicular to arm (224) and parallel to body (226).
  • actuator (216) includes outer engagement feature (231).
  • Outer engagement feature (231) may include upper and lower projections configured to strengthen the interface between slider (214) and actuator (216). Particularly, outer engagement feature (231) is shown as including upper and lower L-shaped arcuate outer projections (236, 238). However, it is also envisioned that outer engagement feature (231) may have a variety of suitable shapes and sizes.
  • Upper and lower L-shaped arcuate outer projections (236, 238) extend in opposite directions away from arm (224).
  • Upper L-shaped arcuate outer projection (236) includes an upper tip portion (237). As shown in FIGS. 14 and 16 , upper tip portion (237) includes a vertical interface surface (239a) and a horizontal interface surface (239b).
  • lower L-shaped arcuate outer projection (238) includes a lower tip portion (240).
  • lower tip portion (240) includes a vertical interface surface (241a) and a horizontal interface surface (241b).
  • Upper and lower tip portions (237, 240) of upper and lower L-shaped arcuate outer projections (236, 238) are shown as extending parallel to arm (224) of actuator (216).
  • a lower half of actuator (216) is a mirror image of upper half of actuator (216).
  • Upper body portion (218) includes first and second arms (242, 244) that are separated by a longitudinal slot (246) (shown in FIG. 12 ).
  • First and second arms (242, 244) of upper body portion (218) include an inner engagement feature (248) and an outer engagement feature (249).
  • inner engagement feature (248) is an upper arcuate inner recess (250) that opens into longitudinal slot (246) and (downwardly) toward lower body portion (220).
  • Upper arcuate inner recess (250) is configured to securably receive and retain upper arcuate inner projection (232) of inner engagement feature (230) of actuator (216).
  • Longitudinal slot (246) is configured to receive central body portion (222).
  • longitudinal slot (246) is configured to accommodate and receive a distal projection (252) of central body portion (222).
  • Upper body portion (218) includes a lower distal projection (254) (shown in FIGS. 12 and 14 ) that is configured to be received within a distal slot (256) of lower body portion (220).
  • upper body portion (218) includes outer engagement feature (249), which is shown an upper arcuate outer recess (251).
  • outer engagement feature (249) may have a variety of suitable shapes and sizes.
  • Upper arcuate outer recess (251) opens upwardly in an opposite direction than upper arcuate inner recess (250).
  • Upper arcuate outer recess (251) includes a vertical interface surface (253a) and a horizontal interface surface (253b) that are shown as being perpendicular to each other.
  • Lower body portion (220) includes first and second arms (258, 260) that are separated by a longitudinal slot (262) (shown in FIG. 12 ).
  • First and second arms (258, 260) of lower body portion (220) include an inner engagement feature (264) and an outer engagement feature (265).
  • Inner engagement feature (264) is configured to securably receive and retain inner engagement feature (230) of actuator (216).
  • inner engagement feature (264) is a lower arcuate inner recess (266) that opens into longitudinal slot (262).
  • Upper and lower arcuate inner recesses (250, 266) of upper and lower body portions (218, 220) collectively define a cavity (268) that collectively capture upper and lower arcuate inner projections (232, 234) of inner engagement feature (230) of actuator (216) within cavity (268).
  • Longitudinal slot (262) is configured to receive central body portion (222).
  • lower body portion (220) includes lower rails (270). Actuator (216) may be rotated relative to slider (214) until actuator (216) contacts a stop feature (274) of upper body portion (218) and a stop feature (276) of lower body portion (220).
  • lower body portion (220) includes outer engagement feature (265), which is shown a lower arcuate outer recess (272).
  • outer engagement feature (265) may have a variety of suitable shapes and sizes.
  • Lower arcuate outer recess (272) opens upwardly in an opposite direction than lower arcuate inner recess (266).
  • Lower arcuate outer recess (272) includes a vertical interface surface (273a) and a horizontal interface surface (273b) that are shown as being perpendicular to each other.
  • Central body portion (222) is similar to central body portion (122) and is described in greater detail below with reference to FIGS. 11-14 . As shown in FIGS. 12 and 14 , central body portion (222) includes an inner engagement feature (275) and an outer engagement feature (277). Inner engagement feature (275), shown as C-shaped engagement feature (278), engages upper and lower arcuate inner projections (232, 234) of inner engagement feature (230) of actuator (216). C-shaped engagement feature (278) includes upper and lower opposing retention features (280, 282) that are shown as being vertically oriented. C-shaped engagement feature (278) forms a cavity (284) that receives upper and lower arcuate inner projections (232, 234) of inner engagement feature (230) of actuator (216).
  • Central body portion (222) includes lower rails (286).
  • Lower rails (270) of lower body portion (220) and lower rails (286) of central body portion (222) are configured to slide along elongate channel (109), along proximal frame portion (18), to vertically guide slider (214) when moved distally.
  • C-shaped engagement feature (288) collectively formed by upper and lower body portions (218, 220) is engaged with upper and lower arcuate inner projections (232, 234) of inner engagement feature (230) of actuator (216). As shown in FIGS.
  • C-shaped engagement feature (278) of central body portion (222) and C-shaped engagement feature (288) collectively formed by upper and lower body portions (218, 220) create cavities (268, 284) that are aligned to provide a track to prevent inner engagement feature (230) of actuator (216) from detaching.
  • central body portion (222) includes outer engagement feature (277).
  • Outer engagement feature (277) of central body portion (122) includes upper and lower arcuate outer recesses (290, 292) that, together with upper and lower arcuate outer recesses (251, 272) of upper and lower body portions (118, 120), are configured to receive outer engagement feature (231) of actuator (216).
  • Upper arcuate outer recess (290) includes a vertical interface surface (294a) and a horizontal interface surface (294b).
  • Lower arcuate outer recess (292) includes a vertical interface surface (296a) and a horizontal interface surface (296b).
  • FIGS. 15-17 show engagement of slider (214) and actuator (216) in greater detail.
  • FIG. 15 shows a cross-sectional perspective view of firing assembly of FIG. 11 taken along from another view, where inner engagement feature (shown as inner engagement features (248, 264, 275)) of slider (214) is engaged at a first interface with an inner engagement feature (230) of actuator (216) and outer engagement feature (shown as outer engagement features (249, 265, 277)) of slider (214) is engaged at a second interface with outer engagement feature (231) of actuator (216).
  • FIG. 16 shows an enlarged cross-sectional perspective view of an enlarged portion of FIG. 15 .
  • FIG. 17 shows a perspective view of firing assembly (212) of FIG. 11 taken along from another view, where inner engagement feature of slider (214) is engaged with an inner engagement feature (230) of actuator (216) and inner engagement feature of slider (214) is coupled with inner engagement feature (230) of actuator (216).
  • Inner engagement feature (230) of actuator (216) is configured to engage inner engagement feature (shown as inner engagement features (248, 264, 275)) of slider (214) at the first interface (e.g. an inner interface), when actuator (216) moves relative to slider (214).
  • inner engagement feature shown as inner engagement features (248, 264, 275)
  • first interface e.g. an inner interface
  • upper and lower arcuate inner projections (232, 234) of inner engagement feature (230) of actuator (216) are securably received within cavities (168, 184).
  • upper and lower arcuate inner projections (232, 234) are configured to slide along respective upper and lower arcuate recesses when actuator (216) moves relative to slider (214).
  • Upper and lower arcuate outer recesses (251, 272) collectively extend a first lateral side (298) of slider (214) and a second lateral side (300) to guide upper and lower arcuate inner projections (232, 234) of actuator (216) between first and second lateral sides (298, 300) of slider (214).
  • Outer engagement feature (231) of actuator (216) is configured to engage outer engagement feature (shown as outer engagement features (249, 265, 277)) of slider (214) at the second interface (e.g. an outer interface), when actuator (216) moves relative to slider (214).
  • outer engagement feature (231) of actuator (216) may slide along outer engagement feature of slider (214), when actuator (216) moves between first and second lateral sides (298, 300) of slider (214).
  • Upper and lower L-shaped arcuate outer projections (236, 238) move relative to outer recesses of upper, lower, and central body portions (218, 220, 222).
  • Upper and lower L-shaped arcuate outer projections (236, 238) are configured to be received in respective upper and lower outer arcuate recesses (251, 272) of upper and lower body portions (218, 220) and upper and lower outer arcuate recesses (290, 292) of central body portion (222) of slider (214).
  • upper L-shaped arcuate outer projection (236) is configured to slide along upper arcuate outer recesses (251, 290) when actuator (216) moves relative to slider (214), and lower L-shaped arcuate outer projection (238) is configured to slide along lower arcuate outer recesses (272, 292) when actuator (216) moves relative to slider (214).
  • upper arcuate outer recesses (251, 290) and lower arcuate outer recesses (272, 292) extend from first lateral side (298) of slider (214) to second lateral side (300) of slider (214), such that upper arcuate outer recesses (251, 290) and lower arcuate outer recesses (272, 292) of upper, lower, and central body portions (218, 220, 222) collectively retain and guide upper and lower L-shaped arcuate outer projections (236, 238) of actuator (216) between first and second lateral sides (298, 300) of slider (214).
  • Upper and lower tip portions (237, 240) are configured to be received in respective upper arcuate outer recesses (251, 290) and lower arcuate outer recesses (272, 292) of slider (214).
  • Relative spacing between upper and lower arcuate inner projections (232, 234) of inner engagement feature (230) of actuator (216) are configured to securably receive and maintain inner engagement feature (230) of actuator (216) within cavities (268, 284).
  • Outer engagement features (shown as outer engagement features (249, 265, 277)) of slider (214) and actuator (216) provide at least one additional contact point to strengthen the second interface between slider (214) and actuator (216). As shown, the second interface is spaced from the first interface. Additional contact points are configured to limit deflection of actuator (216) relative to slider (214) to improve coupling of slider (214) and actuator (216). As shown in FIGS. 15-17 , vertical interface surface (239a) of upper tip portion (237) of actuator (216) slides against vertical interface surface (253a) of upper body portion (218) and horizontal interface surface (239b) of upper tip portion (237) of actuator (216) slides against horizontal interface surface (253b) of upper body portion (218).
  • FIG. 18 shows a proximal perspective view of another exemplary linear surgical stapler (310).
  • Linear surgical stapler (310) is generally similar to linear surgical stapler (10) described above, except as where otherwise described below. Similar to linear surgical stapler (10), linear surgical stapler (310) includes a first elongate member (shown previously as anvil half (14)), a second elongate member (shown previously as cartridge half (12)), and a clamp member (shown previously as clamp lever (24)). As previously described with reference to linear surgical stapler (10), anvil half (14) includes a distal portion (shown previously as distal jaw portion (54)) that supports an anvil surface (shown as anvil plate (60)), where anvil plate (60) includes a plurality of staple forming pockets.
  • anvil half (14) includes a distal portion (shown previously as distal jaw portion (54)) that supports an anvil surface (shown as anvil plate (60)), where anvil plate (60) includes a plurality of staple forming pockets.
  • firing assembly (312) is translatable from a first longitudinal position to a second longitudinal position to fire staple cartridge (80) when anvil half (14) is clamped against cartridge half (12).
  • cartridge half (12) includes a distal portion (shown as distal jaw portion (20)) configured to receive staple cartridge (80), and clamp lever (24) is operable to releasably clamp anvil half (14) against cartridge half (12).
  • firing assembly (312) includes a slider (314) and an actuator (316).
  • Slider (314) includes a first body portion (shown as upper body portion (318)) and a second body portion (shown as lower body portion (320)). Slider (314) may include a central body portion (not shown), but similar to central body portion (122).
  • Actuator (316) includes a body (326) that may include gripping features (328) for improved gripping by a user.
  • Actuator (316) is shown as including upper and lower projections (330, 332) that are configured to slidably engage shrouds (370, 374) of linear surgical stapler (310). As shown in FIG.
  • shroud (374) is similar to shroud (74), and includes an upper ledge (376).
  • Upper ledge (376) includes a vertical interface surface (378a) and horizontal interface surface (378b). As shown, vertical interface surface (378a) is disposed at a 90-degree angle relative to horizontal interface surface (378b).
  • shroud (370), similar to shroud (70), includes a lower ledge (380) that is configured to engage lower projection (332) of actuator (316).
  • Lower ledge (380) includes a vertical interface surface (382a) and horizontal interface surface (382b).
  • vertical interface surface (382a) is disposed at a 90-degree angle relative to horizontal interface surface (382b).
  • FIG. 19 shows a top view of upper projection (330) of actuator (316) of FIG. 18 is engaged with upper ledge (376) of shroud (374) of linear surgical stapler (310) of FIG. 18 .
  • the interface between actuator (316) and shrouds (370, 374) brings actuator (316) to a 90-degree angle to shrouds (370, 374) and tightens the overhang for more engagement with upper and lower ledges (376, 380).
  • the interface between actuator (316) and shrouds (370, 374) also may minimize separation of upper and lower body portions (318, 320) of slider (314).
  • any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the teachings, expressions, embodiments, examples, etc. described in U.S. App. No. 15/889,363, entitled “Release Mechanism for Linear Surgical Stapler,” filed on February 6, 2018 ; U.S. App. No. 15/889,370, entitled “Lockout Assembly for Linear Surgical Stapler,” filed on February 6, 2018 ; U.S. App. No. 15/889,374, entitled “Features to Align and Close Linear Surgical Stapler”,” filed on February 6, 2018 ; U.S. App. No.
  • Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures.
  • various teachings herein may be readily incorporated into a robotic surgical system such as the DAVINCI TM system by Intuitive Surgical, Inc., of Sunnyvale, California.
  • Versions of the devices described above may be designed to be disposed of after a single use, or they can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, some versions of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, some versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by a user immediately prior to a procedure.
  • reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
  • versions described herein may be sterilized before and/or after a procedure.
  • the device is placed in a closed and sealed container, such as a plastic or TYVEK bag.
  • the container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons.
  • the radiation may kill bacteria on the device and in the container.
  • the sterilized device may then be stored in the sterile container for later use.
  • a device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

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Claims (13)

  1. Agrafeuse chirurgicale (10) comprenant :
    (a) un premier élément allongé (14) ayant une partie distale (54) qui supporte une surface d'enclume (60), la surface d'enclume comportant une pluralité de poches de formation d'agrafes ;
    (b) un deuxième élément allongé (12) ayant une partie distale (20) conçue pour recevoir une cartouche d'agrafes (80) ;
    (c) un élément de serrage (24) pouvant être mis en œuvre pour serrer de manière libérable le premier élément allongé contre le deuxième élément allongé ; et
    (d) un ensemble de décharge (212), l'ensemble de décharge pouvant effectuer une translation d'une première position longitudinale à une deuxième position longitudinale pour décharger la cartouche d'agrafes lorsque le premier élément allongé est serré contre le deuxième élément allongé, l'ensemble de décharge comprenant :
    (i) un coulisseau (214) qui comprend :
    (A) un élément d'entrée en prise interne (248, 264, 275), et
    (B) un élément d'entrée en prise externe (249, 265, 277), et
    (ii) un actionneur (216) conçu pour être actionné de manière sélective par un utilisateur, l'actionneur comprenant :
    (A) un élément d'entrée en prise interne (230) conçu pour entrer en prise avec l'élément d'entrée en prise interne du coulisseau au niveau d'une première interface lorsque l'actionneur se déplace par rapport au coulisseau, et
    (B) un élément d'entrée en prise externe (231) conçu pour entrer en prise avec l'élément d'entrée en prise externe du coulisseau au niveau d'une deuxième interface lorsque l'actionneur se déplace par rapport au coulisseau, la deuxième interface étant espacée de la première interface, l'élément d'entrée en prise externe de l'actionneur comportant une première saillie externe (236),
    caractérisée en ce que l'élément d'entrée en prise externe du coulisseau comporte un premier renfoncement externe (251, 290), la première saillie externe étant conçue pour coulisser le long du premier renfoncement externe lorsque l'actionneur se déplace entre un premier côté latéral du coulisseau et un deuxième côté latéral du coulisseau.
  2. Agrafeuse chirurgicale selon la revendication 1, l'élément d'entrée en prise externe du coulisseau étant formé dans une surface externe du coulisseau.
  3. Agrafeuse chirurgicale selon la revendication 1, l'élément d'entrée en prise externe du coulisseau comportant un deuxième renfoncement externe (272, 292), l'élément d'entrée en prise externe de l'actionneur comportant une deuxième saillie externe (238), la deuxième saillie externe étant conçue pour coulisser le long du deuxième renfoncement externe lorsque l'actionneur se déplace par rapport au coulisseau.
  4. Agrafeuse chirurgicale selon la revendication 3, les première et deuxième saillies externes de l'actionneur comportant des saillies externes arquées supérieure et inférieure (236, 238), les premier et deuxième renfoncements externes du coulisseau comportant des renfoncements externes arqués supérieur et inférieur (251, 290, 272, 292), les saillies externes arquées supérieure et inférieure étant conçues pour coulisser le long des renfoncements externes arqués supérieur et inférieur, respectivement, lorsque l'actionneur se déplace par rapport au coulisseau.
  5. Agrafeuse chirurgicale selon la revendication 3, l'actionneur comportant un corps (226) et un bras (224) qui s'étend perpendiculairement au corps, les première et deuxième saillies externes comportant des première et deuxième saillies externes en forme de L (236, 238) qui s'étendent depuis le bras, les première et deuxième saillies externes en forme de L étant conçues pour être reçues dans les premier et deuxième renfoncements externes respectifs du coulisseau.
  6. Agrafeuse chirurgicale selon la revendication 5, les première et deuxième saillies en forme de L comportant des première et deuxième parties terminales (237, 240), les première et deuxième parties terminales des première et deuxième saillies externes en forme de L s'étendant parallèlement au bras de l'actionneur et étant conçues pour être reçues dans les premier et deuxième renfoncements externes respectifs du coulisseau.
  7. Agrafeuse chirurgicale selon la revendication 5, l'élément d'entrée en prise interne de l'actionneur comportant des première et deuxième saillies internes (232, 234) qui s'étendent à l'opposé l'une de l'autre et perpendiculairement au bras de l'élément d'entrée en prise externe de l'actionneur.
  8. Agrafeuse chirurgicale selon la revendication 7, les première et deuxième saillies externes en forme de L et les première et deuxième saillies internes étant arquées.
  9. Agrafeuse chirurgicale selon la revendication 1, l'élément d'entrée en prise interne du coulisseau comportant un élément d'entrée en prise en forme de C (278), l'élément d'entrée en prise en forme de C formant une cavité conçue pour recevoir l'élément d'entrée en prise interne de l'actionneur.
  10. Agrafeuse chirurgicale selon la revendication 9, l'élément d'entrée en prise interne de l'actionneur comportant des première et deuxième saillies internes opposées (232, 234) qui s'étendent à l'opposé l'une de l'autre, les première et deuxième saillies internes étant conçues pour être reçues à l'intérieur de la cavité de manière à pouvoir y être attachées solidement.
  11. Agrafeuse chirurgicale selon la revendication 1, le coulisseau comportant des première et deuxième parties de corps (218, 220) qui comportent chacune des premier et deuxième renfoncements externes (251, 272), l'élément d'entrée en prise externe du coulisseau comportant les premier et deuxième renfoncements externes qui sont conçus pour recevoir l'élément d'entrée en prise externe de l'actionneur.
  12. Agrafeuse chirurgicale selon la revendication 11, le coulisseau comportant une troisième partie de corps (222) qui comporte des éléments d'entrée en prise interne et externe (275, 277), l'élément d'entrée en prise externe de la troisième partie de corps comportant des premier et deuxième renfoncements externes (290, 292) qui, conjointement avec les premier et deuxième renfoncements externes des première et deuxième parties de corps, sont conçus pour recevoir l'élément d'entrée en prise externe de l'actionneur.
  13. Agrafeuse chirurgicale selon la revendication 12, les premier et deuxième renfoncements externes des première, deuxième et troisième parties de corps, collectivement, s'étendant le long d'un premier côté latéral du coulisseau et d'un deuxième côté latéral pour guider l'élément d'entrée en prise externe de l'actionneur entre les premier et deuxième côtés latéraux du coulisseau.
EP20174021.4A 2019-05-13 2020-05-12 Structure de support d'actionneur pour agrafeuse chirurgicale Active EP3738523B1 (fr)

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US16/410,006 US11166715B2 (en) 2019-05-13 2019-05-13 Actuator support structure for surgical stapler

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EP3738523A2 EP3738523A2 (fr) 2020-11-18
EP3738523A3 EP3738523A3 (fr) 2021-01-13
EP3738523B1 true EP3738523B1 (fr) 2023-11-22
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JP (1) JP7487231B2 (fr)
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US20200360015A1 (en) 2020-11-19
JP2022532364A (ja) 2022-07-14
EP3738523A3 (fr) 2021-01-13
EP3738523C0 (fr) 2023-11-22
EP3738523A2 (fr) 2020-11-18
JP7487231B2 (ja) 2024-05-20
PL3738523T3 (pl) 2024-04-02
WO2020229943A1 (fr) 2020-11-19
US11166715B2 (en) 2021-11-09
CN113853171A (zh) 2021-12-28
US20220039794A1 (en) 2022-02-10
BR112021022824A2 (pt) 2022-04-12
US11801049B2 (en) 2023-10-31

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